A difficulty arises when a wound is diagnosed. With regard to penetrating trauma, by way of example only and not by way of limitation, wounds are created by objects which impale the body. These wounds include an observable external wound and additional unknown internal damage as well. Such injuries are caused by knives and guns, for example only.
Where the injury or wound is located determines what types of diagnostic assessments are currently available. If an injury, such as a stab wound to the anterior portion of the abdomen occurs, the current standard diagnostic assessment at many institutions is to lengthen the incision under local anesthesia to explore the internal wound to its base. If the wound penetrates deeper than the most anterior abdominal fascia, the outermost covering of the abdominal muscles, then some physicians perform an operation to determine if an injury has occurred within the abdominal cavity itself. Under this same scenario, however, some physicians perform an invasive procedure called a diagnostic peritoneal lavage (“DPL”). DPL is a procedure where a catheter is introduced into the abdomen and fluid is placed into the abdominal cavity. The fluid is then removed and sent for laboratory analysis. If the DPL is “positive” it means that the abdominal cavity has been penetrated and the patient is taken to the operating room for exploratory surgery; if “negative” the patient is admitted to the hospital for observation.
Penetrating trauma to the back and flanks is more problematic, however, because the posterior part of the abdomen, where structures such as the aorta, vena cava, kidneys, rectum, duodenum and pancreas are located, is not in communication with the abdominal cavity. This means that DPL assessments are useless in evaluating injuries in these locations. At a very minimum, therefore, patients with injuries in these locations will be admitted to the hospital for observation.
Thus, penetrating injuries produce a problematic scenario for physicians because without obvious signs that indicate the need for immediate exploration of the wound, a series of less than satisfactory diagnostic procedures are employed to try to delineate the extent of internal, underlying injuries in order to avoid unnecessary operations. The current state of medical practice includes imaging capabilities that have helped eliminate some “exploratory surgeries”. For example, computerized tomography (“CT”) is the leading diagnostic procedure of choice for trauma in general. However, traumatologists do not embrace CT evaluation for diagnosis of penetrating trauma due to the fear of missed injuries related to using a noncontrasted CT for evaluation of these injuries.
Thus, there is a need in the art for an apparatus and method to place radio-opaque contrast into traumatic wounds in order for CT delineation of both the depth and course of the tract of injury as well as potential injury to vital structures. Such an apparatus and method would enable physicians to diagnose patients suffering from penetrating trauma without the need for invasive procedures, such as wound exploration and DPL. Further, such a system would have other advantages including avoidance of non therapeutic operations and the possibility of discharge from hospital facilities directly out of the emergency department if the study is negative, thereby saving time, cost, resources and lives. It, therefore, is an object of this invention to provide an apparatus and method for placing radio opaque contrast fluid in a wound while sealing the wound and thus enabling CT evaluation of penetrating trauma quickly and inexpensively and without need for invasive diagnostic assessments.